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[Laparoscopic cholecystectomy at an oncologic center: a comparative analysis]
L F Oñate-Ocaña1, R J Mondragón-Sánchez, J M Ruiz-Molina
1Departamento de Gastroenterología, Instituto Nacional de Cancerología, México, D.F.
Revista De Gastroenterologia De Mexico
|April 1, 1997
Summary
Laparoscopic cholecystectomy (LC) offers lower morbidity, mortality, and hospital stays compared to open cholecystectomy (OC) in cancer patients. LC is a safe and recommended option for symptomatic gallstones, even with prior cancer treatments.
Area of Science:
- Oncology
- Surgical Gastroenterology
Background:
- Cholecystectomy is a common procedure for symptomatic gallstones.
- Previous abdominal surgeries or radiation can complicate cholecystectomy.
- Laparoscopic cholecystectomy (LC) has become the standard for uncomplicated gallstone disease.
Purpose of the Study:
- To compare the outcomes of laparoscopic cholecystectomy (LC) versus open cholecystectomy (OC) in patients with a history of cancer.
- To evaluate the safety and efficacy of LC in a complex patient population.
Main Methods:
- A case-control study was conducted at an oncologic referral center.
- Patients were divided into two groups based on the timing of surgery: open cholecystectomy (OC) in the first 30 months and laparoscopic cholecystectomy (LC) in the subsequent 30 months.
- Outcomes including morbidity, mortality, and hospital stay were compared between the groups.
Main Results:
- Laparoscopic cholecystectomy (LC) demonstrated significantly lower morbidity, mortality rates, and shorter hospital stays compared to open cholecystectomy (OC).
- The conversion rate for LC was 14%, higher in patients with prior upper abdominal surgeries.
- No significant differences in morbidity or mortality were observed between groups for patients with prior abdominal surgeries or diabetes; however, patients with liver cirrhosis in the OC group experienced higher morbidity and mortality.
Conclusions:
- Laparoscopic cholecystectomy (LC) is a safe and effective treatment for symptomatic gallstones in patients with a history of cancer, prior laparotomy, or abdominal radiation therapy.
- LC should be considered the first choice for these patients, including those with diabetes and liver cirrhosis.
- Careful technique, such as direct vision trocar insertion, is recommended for patients with prior upper abdominal surgery to manage potentially high conversion rates.